Morimoto Atsushi, Hasegawa Hiroshi, Cheng Heng-Jie, Little William C, Cheng Che-Ping
Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA.
Am J Physiol Heart Circ Physiol. 2004 Jun;286(6):H2425-33. doi: 10.1152/ajpheart.01045.2003. Epub 2004 Feb 12.
The objective of the present study was to test the hypothesis that endogenous beta(3)-adrenoreceptor (AR) activation contributes to left ventricular (LV) and cardiomyocyte dysfunction in heart failure (CHF). Stimulation of the beta(3)-AR inhibits cardiac contraction. In the failing myocardium, beta(3)-ARs are upregulated, suggesting that stimulation of beta(3)-ARs may contribute to depressed cardiac performance in CHF. We assessed the functional significance of endogenous beta(3)-AR activation in 10 conscious dogs before and after pacing-induced CHF. Under normal conditions, L-748,337, a specific beta(3)-AR antagonist, produced a mild increase in LV contractile performance assessed by the slope (E(es)) of the LV pressure-volume relation (18%, 6.2 +/- 0.9 vs. 7.3 +/- 1.2 mmHg/ml, P < 0.05) and the improved LV relaxation time constant (tau; 28.4 +/- 1.9 vs. 26.8 +/- 1.0 ms, P < 0.05). After CHF, the plasma norepinephrine concentration increased eightfold, and L-748,337 produced a larger increase in E(es) (34%, 3.8 +/- 0.7 vs. 5.1 +/- 0.8 mmHg/ml, P < 0.05) and a greater decrease in tau (46.4 +/- 4.2 vs. 41.0 +/- 3.9 ms, P < 0.05). Similar responses were observed in isolated myocytes harvested from LV biopsies before and after CHF. In the normal myocyte, L-748,337 did not cause significant changes in contraction or relengthening. In contrast, in CHF myocytes, L-748,337 produced significant increases in contraction (5.8 +/- 0.9 vs. 6.8 +/- 0.9%, P < 0.05) and relengthening (33.5 +/- 4.2 vs. 39.7 +/- 4.0 microm/s, P < 0.05). The L-748,337-induced myocyte response was associated with improved intracellular Ca(2+) concentration regulation. In CHF myocytes, nadolol caused a decrease in contraction and relengthening, and adding isoproterenol to nadolol caused a further depression of myocyte function. Stimulation of beta(3)-AR by endogenous catecholamine contributes to the depression of LV contraction and relaxation in CHF.
本研究的目的是验证内源性β3-肾上腺素能受体(AR)激活导致心力衰竭(CHF)时左心室(LV)和心肌细胞功能障碍这一假说。β3-AR刺激可抑制心脏收缩。在衰竭心肌中,β3-AR上调,提示β3-AR刺激可能导致CHF时心脏功能降低。我们评估了起搏诱导CHF前后10只清醒犬体内内源性β3-AR激活的功能意义。在正常情况下,特异性β3-AR拮抗剂L-748,337使通过LV压力-容积关系斜率(E(es))评估的LV收缩功能轻度增加(18%,6.2±0.9对7.3±1.2 mmHg/ml,P<0.05),并改善LV舒张时间常数(τ;28.4±1.9对26.8±1.0 ms,P<0.05)。CHF后,血浆去甲肾上腺素浓度增加了8倍,L-748,337使E(es)有更大增加(34%,3.8±0.7对5.1±0.8 mmHg/ml,P<0.05),τ有更大降低(46.4±4.2对41.0±3.9 ms,P<0.05)。在CHF前后从LV活检获取的分离心肌细胞中观察到类似反应。在正常心肌细胞中,L-748,337未引起收缩或再延长的显著变化。相反,在CHF心肌细胞中,L-748,337使收缩(5.8±0.9对6.8±0.9%,P<0.05)和再延长(33.5±4.2对39.7±4.0 μm/s,P<0.05)显著增加。L-748,337诱导的心肌细胞反应与细胞内Ca2+浓度调节改善相关。在CHF心肌细胞中,纳多洛尔使收缩和再延长降低,向纳多洛尔中加入异丙肾上腺素使心肌细胞功能进一步降低。内源性儿茶酚胺对β3-AR的刺激导致CHF时LV收缩和舒张功能降低。